Individual
SHANE PALMER BRAIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5113 SE 15TH ST STE A, DEL CITY, OK 73115-3952
(405) 600-3252
Mailing address
100 N UNIVERSITY DR, EDMOND, OK 73034-5207
(405) 974-3632
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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